The path to patient centricity: Are we nearly there yet?

Healthcare is like a supertanker, steaming its course, slow to manoeuvre, with a destination decided at the start of the voyage which may not be the right one by its end.

And the supertanker is sinking.

The cargo is fast growing in mass, changing in nature and rising in cost.

What do you do? Try and fix the supertanker? Expensive. Throw some of the cargo overboard? Unfair.

A lot of intelligent thinking has been applied to the challenges facing the healthcare sector. What is unanimously clear from the opinions of industry experts is that technology and data will bring about significant shifts in the roles of providers, payers and patients.

To continue the metaphor, huge supertanker health systems will have to use technology to become more agile. Patients will be empowered through data to better navigate their own routes to better health.

Advances in technologies such as cloud computing and artificial intelligence offer new opportunities to innovate quickly and at scale. The ubiquity and power of the smartphone put new services and tools quite literally in the hands of patients.

Shiny appy people

Those smartphones and apps will drive much of the change that patients will experience at first hand. While around two thirds of phones currently have embedded biometric technology, such features will be ubiquitous by 2019.

The number of available health apps last year reached 325,000, of which 78,000 were new app store releases, according to Research2Guidance, with health insurers the main market driver.

In its Life sciences and health care predictions 2022 report, Deloitte envisions a future in which “interactive ‘health app libraries’ help people choose the most appropriate health apps and digital technologies and signpost individuals to a suite of approved digital health engagement tools”, and “people share their health data willingly with health providers, much like consumer data”.

Patient groups, it says, self organise into support networks where knowledge is crowd-sourced and best practice shared.

“Payers and providers have created more patient-centric care delivery models that involve increased collaboration and shared decision making”, the report says. “Health apps and digital technologies are ‘kite-marked’ to demonstrate they meet global compliance standards.”

Its goes on to explain what that ‘patient-centric care’ means for patients and providers: “Patients control access to their health data, granting access to their electronic health records (EHRs) to all health providers, as and when needed. The digital hospital leverages technologies to optimise care delivery, patient experience, staff deployment and the management of back-office services, reducing costs and improving outcomes.”

Significantly, the report sees data as “the new healthcare currency” worthy of significant funding as a “national infrastructure priority”.

Crucially, it goes on to see this as a market in which “all stakeholders now accept that the patient owns their own data, and patients readily give consent for their health and social care data to be used.”

However, healthcare lags behind other sectors when it comes to digital innovation, it says: “Technology is already transforming how people live, work and play, but the healthcare sector has, to date, not been able to take advantage of these developments. In many cases, it’s playing catch up with other industries. Some of this is down to under investment and some to the failed legacy of previous IT programmes such as the National Programme for IT.”

Make a virtue of patients

People, rather than tech, are the key to success for ATOS, too. Introducing the Digital Vision for Healthopinion paper, CEO Adrian Gregory says: “While technology is an important enabler, it is people – patients, clinicians, carers and families – who must be at the centre of any technological change. . . Wider use of mobile devices can put more information into the hands of citizens, support personalised care plans for people at home, and increase the productivity of clinical teams.

“People need access to the right information about themselves and their treatment, at the right time and in the right format; it’s the difference between good and poor care. The technologies, of course, exist. This is about making a cultural shift towards treating patients as consumers of health and care services.”

Accenture takes a similar line in its Digital Health Technology Vision 2017report, stating: “Healthcare organisations have begun to realise that healthcare should be organised around the patient, not the enterprise.”

All they need to do is plug in the patients – and their data.

“Healthcare enterprises can integrate their core functionality with digital platforms through application programming interfaces (APIs), making it easier for all to plug into and play in the broader ecosystem, facilitating patient-centred care.”

The report adds: “By considering and responding to human behaviour, businesses have the opportunity to create richer, more responsive journeys with customers, clinicians and administrators, transforming relationships into true partnerships that improve the health system for everyone.”

Treat the symptoms

But what about the need driving all these shiny new ideas?

Well, the statistics tell us that a revolution in healthcare provision is a must, not a want.

Populations are growing and life expectancy is rising, certainly in developed countries. Over-65s will number 604million by 2020, comprising 11 per cent of the world’s people and nearly a fifth of Europeans, according to Deloitte. Global healthcare spending will hit $8.7trillion by then, they add.

Then there is cancer, heart disease and any number of other chronic conditions that are being treated at greater volume as a result of there being more people, who are living longer and enjoying the benefits of better medicine.

We have technology to thank for constantly improving healthcare outcomes. Its potential to empower patients to better manage their own health and the supply-side innovation that enables that to happen offers the potential for massive reductions in administrative burden.

That means enormous cost savings which is obviously good for cash-strapped public health services, but it also means what money there is can be spent far more effectively.

A lean bill of health

So, the direction of travel clearly seems to be in favour of something that strongly resembles Patient Centricity. Services and products that are designed around the individual, with clear market opportunities for doing so. The idea of data being the ‘healthcare currency’ and allowing patients to own and control more of their information.

Perhaps what is missing – or has been missed – is the very essenceof Patient Centricity. While creating apps, services, platforms and APIs that make it easier for individuals to access and share data are all absolutely the right things to do, what about making the patient the source of their health data?

The patient as the single point of integration for all their healthcare data.

Ownership of data? Check. The ability for the individual to access that data and derive insight from it? A given.

All the other factors – most notably the way the ‘currency’ of health data is used by the entire healthcare ecosystem – become more effective if the patient is the foundational common denominator rather than a cog in the machine.

When the patient is the source for all his or her data, the quality of that data is far superior, consent becomes a natural consequence of sharing